Zed Zha, MD, FAAFP

Collaboration Between Primary Care and Dermatology in Atopic Dermatitis Care

Video content above in prompted by the following:

For many patients, a primary care physician may be the first provider they see when presenting with symptoms. When evaluating patients for AD, at what point do you consider referral to a dermatologist?

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Panelists discuss how primary care physicians often serve as the first point of contact for patients with atopic dermatitis symptoms. Dermatologist referral is typically considered when patients show severe or persistent symptoms despite initial treatment, have unclear diagnosis, require specialized therapies, or experience significant impact on quality of life.

Strategies for Determining Severity of Atopic Dermatitis

What are the criteria for classifying atopic dermatitis as mild, moderate, or severe?

Do you use NRS, EASI, SCORAD, POEM, BSA, or other methods?

How important is it that problem areas (such as the hands, feet, or genitals) are emphasized in the assessment for disease severity and impact on the patient?

Panelists discuss how atopic dermatitis severity classification relies on multiple assessment tools including EASI, SCORAD, POEM, and BSA measurements. Special attention is given to sensitive areas (hands, feet, genitals) as they significantly impact quality of life. Disease extent, intensity of symptoms, and functional impairment guide categorization into mild, moderate, or severe cases.

Panelists discuss how they assess atopic dermatitis across all age groups by evaluating clinical history, symptom severity, and physical examination. They consider factors like age-specific presentations, comorbid conditions, and response to treatment for individualized management.

A Primary Care Perspective on Diagnosing Atopic Dermatitis

Provide perspectives on the how panelists assess atopic dermatitis across all age groups.

Panelists discuss how adult atopic dermatitis diagnosis relies on clinical presentation of chronic, pruritic, and eczematous lesions with characteristic distribution patterns. Unlike children, adults show more lichenified plaques and predominant hand/foot involvement. Key diagnostic criteria include personal/family history of atopy and chronic/relapsing course. No definitive test exists.

Considerations for Diagnosis of Atopic Dermatitis in Adults

Discuss the diagnosis of atopic dermatitis in adults, specifically what’s needed to make the diagnosis and the considerations in adults vs pediatric patients.

Zed Zha, MD, FAAFP

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